0000000000076469
AUTHOR
Miguel Perpiñá
EFFECTS OF PHORBOL 12,13-DIACETATE AND ITS INFLUENCE ON SPASMOGENIC RESPONSES IN NORMAL AND SENSITIZED GUINEA-PIG TRACHEA
Abstract We have studied the effects of phorbol 12,13-diacetate (PDA) and its influence on a variety of spasmogenic responses in trachea isolated in from normal and sensitized guinea-pigs. Tracheal preparations were denuded of epithelium, treated with indomethacin (2·8 μm), and cooled to 20°C. In these experimental conditions, tracheal strips contracted to PDA (0·1 nm-1 μm). Contractions to PDA (1 μm) were greater in sensitized tissues. In normal trachea, contractions to PDA (0·1 μm) were depressed by H-7, 1-(5-isoquinolinyl-sulphonyl)-2-methylpiperazine, (50 μm), amiloride (10 μm), verapamil (10 μm) and Ca2+-free exposure. Similar effects were obtained in sensitized trachea except that PDA…
Prevalence of Hyperventilation Syndrome in Patients Treated for Asthma in a Pulmonology Clinic
Objective Although the presence of hyperventilation syndrome can affect the symptoms of patients with asthma, there is very little information available regarding its frequency in Spain. The aim of this study was to investigate the prevalence of hyperventilation syndrome in the asthmatic population treated as outpatients and establish its relationship with anxiety disorders. Patients and methods We studied 157 consecutive asthmatic patients (61 men and 96 women; mean [SD] age, 45 [17] years; forced expiratory volume in the first second, 84% [21%] of the predicted value) treated in our outpatients clinic. The patients had stable disease with varying degrees of severity. After collecting demo…
[Perception of dyspnea and treatment adherence in asthmatic patients].
OBJECTIVE: The majority of studies show that treatment adherence in chronic diseases such as asthma does not exceed 50%. Although the reasons may vary, it is clear that lack of treatment adherence is a determining factor in poor disease control. An association has also been observed between lack of perception of dyspnea and difficult-to-control asthma and with the occurrence of fatal or near-fatal asthma attacks. In this study we therefore attempted to demonstrate that one of the reasons that asthmatic patients do not adhere to treatment is a failure to perceive dyspnea associated with bronchial obstruction. PATIENTS AND METHODS: We analyzed 2 groups of patients with moderate persistent ast…
Pharmacological analysis of the responsiveness of guinea-pig lung parenchymal strip to dopamine
Abstract Responses to dopamine were examined in the guinea-pig isolated lung parenchymal strip. Complete cumulative concentration-response curves to dopamine exhibited a biphasic pattern with a small initial contraction at concentrations below 10(-5) M followed by a dose-dependent relaxation at higher concentrations. Phentolamine (10(-5) M) completely abolished the contractile component and enhanced sensitivity and maximal relaxation to dopamine. In the presence of phentolamine, propranolol antagonized the dopamine-induced relaxation (pA2 = 8.54 +/- 0.07). In the presence of propranolol (10(-6) M), dopamine produced a dose-related contraction displaced to the right by phentolamine. Incubati…
The Revised Asthma Problem Behavior Checklist: Adaptation for Use in Spanish Asthmatic Patients
Behavioral problems associated with asthma management were examined in a group of 100 adult Spanish outpatients with asthma (57 women, 43 men; 17-69 years of age). All of them completed a Spanish version of the Revised Asthma Problem Behavior Checklist (RAPBC). Data about duration, severity, and self-management of asthma (self-efficacy expectancies and health care utilization), as well as dyspnea and FEV1, were also recorded. The highest-reliability Cronbach alpha indices were for the criteria related to emotions and behaviors that could precipitate asthma attacks. Concurrent criterion validity was examined first by Pearson correlations between the RAPBC scores and clinical data about asthm…
Subjective symptomatology of asthma: validation of the asthma symptom checklist in an outpatient Spanish population.
The objective of this study was to validate the Asthma Symptom Checklist (ASC) so that it could be reliably used to assess the subjective symptomatology of asthma attacks in our context. Subjective symptomatology of asthma was examined in a group of 100 adult Spanish outpatients (57 women, 43 men; 17-69 years of age) with asthma. All of them completed the modified version of the ASC as well as questionnaires of depression, anxiety, and self-management of asthma (self-efficacy expectancies and health care utilization). Data about duration and severity of asthma, as well as dyspnea and %FEV1, were also recorded. The highest reliability Cronbach alpha indexes were for the panic-fear and fatigu…
Does Experience Influence Perception of Dyspnea?
OBJECTIVE: The perception of somatic sensations like dyspnea can be influenced by such factors as an individuals personality, experiences, or ability to adapt to stimuli. Our aim was to determine whether the perception of acute bronchoconstriction is different for patients with asthma and patients who have never experienced an episode of airway obstruction. PATIENTS AND METHOD: We studied 2 groups of patients. The first consisted of 24 subjects with intermittent rhinitis and asthma (10 females and 14 males) with a mean (SD) age of 25 (7) years. All reported not feeling dyspnea at rest on a Borg scale. The second group consisted of 24 subjects who only had rhinitis but no lung disease (no ep…
DIFFERENT ABILITY OF TRIFLUOPERAZINE TO INHIBIT AGONIST-INDUCED CONTRACTION OF LUNG PARENCHYMA STRIPS FROM CONTROL AND SENSITIZED GUINEA-PIGS
Abstract There is increasing interest in the therapeutic potential of calcium antagonists in asthma. Among them the use of calmodulin antagonists deserves consideration. In the present work the effect of trifluoperazine on contractions generated by different mechanisms (CaCl2, KCl, acetylcholine, histamine and 5-hydroxytryptamine) in lung parenchyma strip isolated from control and actively sensitized guinea-pigs has been studied. Trifluoperazine produced both in unsensitized and sensitized lung strips, a concentration-dependent, right, downward displacement of the concentration-response curves to the agonists used, although the sensitization procedure resulted in a potentiation in the abili…
[Evolution over time in over perceivers of dyspnea in asthma].
OBJECTIVE: In previous studies we identified a subgroup of patients whose perception of breathlessness was exaggerated during acute bronchoconstriction and who were termed “over perceivers” or “hyperperceivers.” In this study we aimed to determine whether such over perception is sporadic or stable over time. We also examined whether there is an association between over perception of dyspnea and hyperventilation syndrome. PATIENTS AND METHODS: The subjects were 22 stable asthmatics (11 men, 11 women) who had been over perceivers of dyspnea in a study 9 years earlier. After a medical history was taken, a patient performed forced spirometry and a severity classification was made according to t…
Effects of alkylxanthines on contractility of diaphragm fibres isolated from normal and sensitized guinea-pigs.
Abstract This study investigates the effects of alkylxanthines on twitch tension generated by electrical stimulation (supramaximal pulses, 0·2 ms duration, 1 Hz) of diaphragm muscle fibres isolated from normal and actively-sensitized guinea-pigs. Caffeine, theophylline and theobromine increased, in a concentration-dependent manner (50–500 μm), twitch tension in normal and sensitized diaphragm. Caffeine (500 μm) enhanced contractility to a greater extent than theophylline or theobromine. Twitch potentiation by caffeine (500 μm) was significantly greater in sensitized diaphragm. Verapamil (0·1–100 μm) did not alter twitch contractions in the absence or presence of alkylxanthines in normal or …
Assessment of the reliability, validity, and responsiveness of a Spanish Asthma Quality of Life questionnaire.
A Spanish-language questionnaire designed for measuring the impact of asthma on quality of life in adults was developed. It was derived, by the application of a rigorous translation protocol, from a previously validated, English-language Asthma Quality of Life (AQL) questionnaire which had been developed in Australia. The aim of this study was to evaluate the psychometric properties of the Spanish AQL questionnaire using a cross-sectional and longitudinal design. Two hundred ninety-four clinically stable subjects with asthma (168 women, mean baseline forced expiratory volume in 1 sec [FEV1] = 85% predicted), aged 17-70, attended for the initial baseline assessment. All subjects completed th…
Determinants of Dyspnea in Patients with Different Grades of Stable Asthma
Dyspnea is a main feature of symptomatology in asthma, and its perception does not necessarily correlates well with airway obstruction. The aim of this study was twofold: (1) to identify factors determining the subjective degree of dyspnea in patients with different grades of stable bronchial asthma and (2) to compare various clinical methods existing for grading dyspnea. The investigation comprised 153 outpatients with stable asthma. The parameters studied were the following: demographic characteristic of subjects, baseline dyspnea score by means of three clinical instruments (baseline dyspnea index [BDI], Medical Research Council [MRC] scale, and modified Borg scale), asthma severity, sta…
Concordancia entre la percepción de disnea del asmático durante la obstrucción aguda y crónica
Objetivo Durante la estabilidad clinica se pueden distinguir 3 tipos de asmaticos: hipoperceptores, normoperceptores e hiperperceptores. Cuando a esos mismos pacientes se les provoca una broncoconstriccion aguda, tambien existen hipo, normo e hiperperceptores de disnea. El objetivo del presente trabajo ha sido comprobar la concordancia entre ambas situaciones. Pacientes y metodos Se ha estudiado a 93 pacientes con asma persistente moderada (36 varones y 57 mujeres; edad media de 40 anos). Se les pidio que estimaran su disnea (escala modificada de Borg) en situacion de estabilidad y despues de cada dosis de histamina en una prueba de broncoprovocacion. Cuando la puntuacion de Borg en situaci…
Evolución temporal de la percepción exagerada de disnea en los pacientes con asma
Objetivo: En investigaciones previas para estudiar la percepcion de disnea de los asmaticos durante la broncoconstriccion aguda, encontramos un subgrupo de pacientes que presentaban una percepcion exagerada (hiperperceptores). En el presente trabajo hemos querido comprobar si esta alteracion perceptiva es un fenomeno esporadico o mantenido en el tiempo. Asimismo nos planteamos conocer si existe una asociacion entre la hiperpercepcion de la disnea y el sindrome de hiperventilacion. Pacientes y metodos: Se incluyo en el estudio a 22 asmaticos estables que en un estudio realizado 9 anos antes se habian mostrado hiperperceptores de disnea (11 varones y 11 mujeres). Tras una espirometria forzada…
Effect of serotonin and calcium in normal and sensitized guinea pig isolated trachea
Tracheal strips from normal and actively sensitized guinea pigs were studied to determine the responses to serotonin (5-hydroxytryptamine, 5-HT ; 1 nM - 0.1 mM) and ouabain (0.1 μM - 0.1 mM), and the effects of increasing the extracellular calcium (Ca o ) concentration on tonic contractions elicited by 5-HT. Sensitized trachea exhibited an increased responsiveness and sensitivity to 5-HT and ouabain. Increases in Ca o to achieve final concentrations of 5, 10 and 20 mM caused concentration-related relaxations of normal and sensitized tissues contracted to a similar plateau level with 5-HT. Inhibition of the Na + /K + -ATPase by ouabain (10 μM) reversed the effects of Ca o from relaxation to …
¿Influye la experiencia en la percepción de disnea?
Objetivo: En la percepcion de las sensaciones somaticas, como la disnea, pueden influir factores tales como la propia personalidad del individuo, su experiencia previa o su capacidad de adaptacion a los estimulos. El objetivo del presente estudio ha sido conocer si los pacientes con asma perciben una situacion de broncoconstriccion aguda de forma diferente de los pacientes que nunca han sufrido un episodio previo de obstruccion de la via aerea. Pacientes y metodo: Estudiamos 2 grupos de pacientes. El primero estaba formado por 24 sujetos con rinitis y asma intermitente (10 mujeres y 14 varones, con una edad media ± desviacion estandar de 25 ± 7 anos), que no referian sentir disnea basal en …
Non-specific Hyperreactivity to Pharmacological Stimuli in Tracheal and Lung Parenchymal Strips of Actively Sensitized Guinea-pigs
Abstract The responsiveness of tracheal and lung parenchymal strips isolated from actively sensitized guinea-pigs to CaCl2 (in K+-depolarized tissue), KCl, acetylcholine and histamine was compared with that of strips from unsensitized animals. The concentration-response curves to the mentioned agonists exhibited, in the sensitized group, a left upward displacement (greater maximal effect, lesser effective concentration 50% and a steeper slope) compared with those obtained in the unsensitized group. These results indicate the existence of a non-specific increase in responsiveness in the airway smooth muscle from sensitized animals.
Percepción de la disnea durante la broncoconstricción aguda en los pacientes con asma
El objetivo del estudio fue analizar las variaciones de la percepcion de obstruccion bronquial aguda en los asmaticos de nuestra poblacion e intentar definir las variables que condicionan dichas diferencias interindividuales. Se estudio a 153 asmaticos en situacion estable, midiendo la disnea que percibian en una escala de Borg durante la realizacion de una prueba de provocacion bronquial con histamina. Para el analisis de la percepcion individual se valoraron tanto la PS20 (disnea en la escala de Borg al caer el FEV 1 un 20%) como la diferencia matematica entre la PS20 y la disnea ba-sal (”cambio en Borg“ [CB]). Segun nuestros resultados: a) el conjunto de factores que determinan la PS20 (…
Bronchial asthma and personality dimensions: a multifaceted association.
Personality dimensions seem to play an important role in chronic diseases by maintaining or increasing the patient's physical complaints. This study examines in bronchial asthma: (a) the relationships among clinical data, baseline lung function, and personality traits; and (b) the patient's characteristics related to the physician's judgement about his or her asthma severity. Five questionnaires measuring anxiety, depression, self-consciousness, and subjective symptoms were completed by 51 asthmatic patients. Responses to questionnaires and clinical and demographic data were factor-analyzed. Factor analysis revealed that the physician's severity judgement is based on elderly age, high score…
Percepción de mejoría en los pacientes con asma
Objetivo Investigar la capacidad de los pacientes con asma estable de reconocer la mejoria de su obstruccion bronquial con el tratamiento Metodo Seleccionamos a 75 asmaticos estables (44 mujeres y 31 varones, con una media de edad de 43 ± 17 anos), que referian sentir disnea basal en la escala modificada de Borg, y les provocamos en el laboratorio una broncodilatacion aguda del 15%; en esta situacion los pacientes fueron interrogados acerca del cambio de disnea experimentado Resultados 1. Globalmente, 19 asmaticos (25%) no percibieron mejoria de su disnea con la broncodilatacion. 2. La media del cambio en el nivel de disnea fue de 1,17 ± 1,11; sin embargo, este cambio fue mayor en los pacie…
Responses to histamine and selective H2-receptor agonists in lung parenchymal strips from normal and sensitized guinea-pigs.
Histamine produces concentration-dependent contractions of lung parenchyma strips obtained from normal and sensitized guinea-pigs. The responsiveness of the sensitized lung strips to histamine was significantly increased compared to normal tissues. Clemizole (0.1 microM) was equally effective as an H1-antagonist in normal (dose-ratio 9.12) and sensitized (dose-ratio 9.77) tissues. The concentration-response curves to histamine were displaced to the left by cimetidine (0.1 microM to 0.1 mM) with similar dose-ratios in normal and sensitized tissues. Cimetidine enhanced maximal responses to histamine only in normal lung strips. The effects of submaximal equieffective concentrations of histamin…
Agreement in Asthmatics' Perception of Dyspnea During Acute and Chronic Obstruction
Objective Three types of asthmatic patients can be identified during periods of clinical stability: “poor perceivers,” “normal perceivers,” and “over perceivers.” When asthmatics undergo bronchial challenge in the laboratory, the same distinctions in type of perception can be observed. The aim of the present study was to determine the level of agreement between the 2 situations. Patients and methods A total of 93 patients with persistent moderate asthma (36 men and 57 women; mean age 40 years) were studied. We asked them to assess their dyspnea on a modified Borg scale when stable and after each histamine dose in a bronchial provocation test. When a patient's Borg scale assessment in stable…
Prevalencia del síndrome de hiperventilación en pacientes tratados por asma en una consulta de neumología
Objetivo Aunque la presencia del sindrome de hiperventilacion (SH) puede influir en los sintomas de los pacientes con asma, existe escasa informacion acerca de su frecuencia en nuestro medio. Nuestro objetivo ha sido investigar la prevalencia de SH entre la poblacion asmatica controlada ambulatoriamente y establecer su relacion con los trastornos de ansiedad. Pacientes y metodo Con este proposito hemos estudiado a 157 asmaticos consecutivos (61 varones, 96 mujeres; edad media ± desviacion estandar de 45 ± 17 anos; volumen espiratorio forzado en el primer segundo: 84 ± 21%), controladosen nuestras consultas externas, en situacion estable y con diferentes grados de gravedad. Tras recoger los …
The relaxant effects of cromakalim (BRL 34915) on human isolated airway smooth muscle
Cromakalim (BRL 34915) is a potassium channel opener with therapeutic potential as a bronchodilator in asthma. Cromakalim (0.1–30 μmol/l) inhibited the spontaneous tone of human isolated bronchi n a concentration-related manner being nearly as effective as isoprenaline or theophylline. The order of relaxant potencies (expressed as -log10 IC50 mol/l; mean ±SEM) was isoprenaline (7.29 ± 0.27; n = 8) > cromakalim (5.89 ± 0.12; n = 7) > theophylline (4.07 ±0.13; n = 10). In human bronchi where tone had been raised by addition of histamine (0.1 mmol/l), acetylcholine (0.1 mmol/l) or leukotriene D4 (LTD4, 0.1 μmol/l), the relaxant effect of cromakalim was substantially reduced. Cromakalim suppres…
Percepción de la disnea y cumplimiento terapéutico en pacientes con asma
Objetivo El cumplimiento terapeutico en una enfermedad cronica como el asma no supera el 50% en la mayoria de las series. Aunque las razones sean de muy diversa indole, es evidente que el incumplimiento es un factor determinante en el mal control de la enfermedad. Por otra parte, la falta de percepcion de la disnea se ha asociado con el asma de control dificil y con la aparicion de crisis de asma fatal o casi fatal. Asi pues, el objetivo del presente estudio ha sido intentar demostrar que una de las razones por las cuales los asmaticos no toman su medicacion es que no tienen percepcion de disnea cuando sus bronquios se obstruyen. Pacientes y metodos Hemos estudiado a 2 grupos de pacientes c…
Gender Differences in Health‐Related Quality of Life Among Patients with Asthma
This study has a twofold objective: 1) to explore to what extent suffering from asthma affects the HRQL of men and women differently at several stages of disease severity and 2) to analyze whether the informed poorer HRQL of asthmatic women is related to their higher scores on instruments measuring emotionally disordered symptoms. One hundred fifty-one outpatient asthmatics (84 women and 67 men) completed the Spanish versions of the Asthma Quality of Life questionnaire (AQL), as well as anxiety and depression inventories. A full history, physical examination, and pulmonary function test were performed on all subjects. Patients were classified into one of four asthma severity categories foll…
Effect of dantrolene sodium in isolated guinea-pig trachea.
The effect of dantrolene sodium (3 microM-0.3 mM) on the spontaneous tone and responses to various contractile agonists was studied in isolated guinea-pig trachea. Dantrolene produced a concentration-related inhibition of the spontaneous tracheal tone, reaching a value of 94.8 +/- 4.8% of the relaxation induced by caffeine 10 mM. Removal of the epithelium did not affect the dantrolene-induced relaxation. Dantrolene did not alter the concentration-response curve for KCl and produced only small displacements of the concentration-response curves for CaCl2, acetylcholine and histamine, without affecting their maximal effects. Dantrolene dose relatedly inhibited the contraction induced by caffei…
Calidad de vida en el asma: validación del cuestionario AQLQ para su utilización en población española
The study of morbidity in asthma requires consideration not only of standard physiopathologic and function parameters, but also of the impact the disease has on the patient's life-style as he or she perceives it and evaluates it. The quantification of this factor, known as health-related quality of life (HRQL), is achieved by administering questionnaires specially designed for the purpose. We analyzed the reliability, content validity and construct validity (convergence and divergence) of one instrument, the Asthma Quality of Life Questionnaire (AQLQ) designed by Marks and colleagues. This questionnaire covers 4 dimensions (breathlessness, mood, social limitation and worrying) and gives a t…